Journal of Korean Academy of Nursing

Original Articles

Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer: Pok Ja Oh, Jung Ran Lee; J Korean Acad Nurs 2016;46(3):420-430. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.420

Purpose

The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer.

Methods

A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis.

Results

CRCI was directly affected by cancer symptoms (β=.19, p=.004) and fatigue (β=.56, p<.001)(R²=47.2%). Depression was directly affected by fatigue (β=.48, p<.001) and CRCI (β=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI.

Conclusion

Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.

Citations

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Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress: Pok Ja Oh, Jeong Hye Kim; J Korean Acad Nurs 2016;46(1):19-28. Published online February 29, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.1.19

Abstract PDF

Purpose

The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer.

Methods

A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation.

Results

The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R²=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R²=43%). Psychological distress had a partial mediating effect (β= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001).

Conclusion

Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

Citations

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Eun-Hee Lee, Dongwon Choi
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Senbang Yao, Wen Li, Shaochun Liu, Yinlian Cai, Qianqian Zhang, Lingxue Tang, Sheng Yu, Yanyan Jing, Xiangxiang Yin, Huaidong Cheng
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Comparison of Demographic Characteristics, Comorbidity, and Health Habits of Older Adults with Mild Cognitive Impairment and Older Adults with Normal Cognitive Function: Myonghwa Park, Mi Ra Sung, Sun Kyung Kim, Dong Young Lee; J Korean Acad Nurs 2014;44(4):351-360. Published online August 15, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.4.351

Abstract PDF

Abstract Purpose

This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF).

Methods

Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above.

Results

The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption.

Conclusion

Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.

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A Meta-analysis of Chemotherapy related Cognitive Impairment in Patients with Breast Cancer: Jin-Hee Park, Sun Hyoung Bae; J Korean Acad Nurs 2012;42(5):644-658. Published online October 12, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.5.644

Abstract PDF

Purpose

The purpose of this study was to evaluate the cognitive effects of chemotherapy in patients with breast cancer.

Methods

Using several databases, prospective studies were collected up to August 2011. Of 2,106 publications identified, 12 met the inclusion criteria, and 8 studies were used to estimate the effect size of chemotherapy on cognitive impairment.

Results

Twelve studies were done since 2005 and most of the research was performed in Europe or North America. Eight studies were used to generate effect size across the cognitive domains of attention/concentration, verbal and visual memory, executive function, visuospatial skill, language, and subjective cognitive function. Each of the cognitive domains showed small effect sizes (-0.02 ~ -0.26), indicating diminished cognitive function for the chemotherapy group compared with non-chemotherapy groups.

Conclusion

Finding suggests that breast cancer patients who undergo chemotherapy may experience mild cognitive decline. Further study is needed to generate knowledge and guideline for interventions to address chemotherapy related cognitive impairment in these patients.

Citations

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